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August 1967

An Unrecognized Cause of Baggy Lower Eyelids

Author Affiliations

Los Angeles
From the Department of Plastic Surgery, Midway Hospital, Los Angeles, the departments of rhinology (Dr. Parkes) and surgery (Dr. Griffiths), California College of Medicine, University of California, Los Angeles.

Arch Otolaryngol. 1967;86(2):201-204. doi:10.1001/archotol.1967.00760050203017

BAGGY LOWER EYELIDS are most commonly caused by an attenuation of either or both the septum orbitale and the orbicularis oculi muscle, which results in a forward extension of the peripheral intraocular fat through the orifices adipeux of Charpy1,2 (Fig 1). The occurrence of these fat hernias in association with a variety of conditions has been reported. These include degenerative changes in the epidermis and subcutaneous tissues resulting in skin redundancy;3 allergic conditions, myxedema, or nephrosis that cause intermittent edema and thickening of the lids;3-5 and pathological states such as neoplastic disease, lipoidosis, and exophthalmic goiter, in which intraorbital pressure is increased.3,5,6

The present report records a case of bags beneath the eyes caused by either the absence of or hypoplasia of the septum orbitale, or orbicularis oculi, or both, an anomaly which permitted the intraocular fat to extend into the subcutaneous tissues of the lower

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